Teenage Sleep Issues

We spoke with Dr Michael Gradisar at Flinders University to discuss teenage sleep issues, to help answer some of your questions.

Dr Gradisar’s research interests include the prevalence, consequences, and the psychological assessment and treatment of sleep disorders in children and adolescents.

He also runs treatment studies for child and adolescent sleep problems through the Child and Adolescent Sleep Clinic in Adelaide, Australia

Read the full interview here.

Why do teenagers find it hard to get up in the morning? There are 2 reasons explaining teenager’s difficulties getting up in the morning. First, their body clock which determines what time they fall asleep and what time they should wake up delays as teenager’s develop through their adolescent years. This means that they fall asleep later and wake later. So on a school night, their body clock determines that they should fall asleep later (e.g.12 midnight) than they desire (e.g. 10:30pm), but although their body clock would wake them later (e.g. 9:30am), they have to wake up and get ready for school (e.g. 7:30am). From this example, it is hopefully clear that the second reason for their difficulty waking is that they don’t achieve the sleep they need. These two biological sleep processes therefore compound to make it awful for teens to wake on school mornings.

Is there a common sleep issue that is suffered by teenagers? We have asked hundreds of teenagers whether they think they have a sleep problem, and if so, to describe to us why they think they have a sleep problem. In their words, the most common reasons include, “it takes me a long time to fall asleep”, “I fall asleep late”, “I don’t get enough sleep”, and “It’s hard for me to wake up in the morning”.

Why do teenagers suffer from these sleep issues? The main cause behind these sleep issues is a delayed body clock which makes the timing of their sleep late (i.e. fall asleep late; wake up late). There is some contribution from them worrying when they are taking a long time to fall asleep, and also some impact from the behaviours they perform close to bedtime (for example technology use and socialising)

When can these sleep issues start? Researchers have frequently identified the onset of these problems to occur around the onset of puberty. In our Child & Adolescent Sleep Clinic, we ask teenagers when their sleep problem began. It can be hard for them to identify when it started as it happens slowly, but their responses often suggest during the transition from primary school to high school (which somewhat coincides with the onset of puberty for some teens).

Why is sleep so important to teenagers? From our perspective in the Child & Adolescent Sleep Clinic, we see what happens to teenagers when they don’t achieve adequate sleep. This ranges from not being able to concentrate in class, worrying that they won’t pass tests, get good grades, or even get a good job one day. Their parents say that their teenagers are moody and irritable in the mornings, and that they are often running late in the mornings. But the worse issues occur when the teens are so chronically sleep-deprived that they start missing school, eventually drop-out, and find it incredibly difficult to go back to school. They’ve missed out on plenty of social things with their friends, and they worry about having to catch up on a lot of school work. Some who have not coped with dropping out of school develop other emotional problems (e.g., social anxiety, depression) and the worst case scenarios have been when they have thought of taking their own life or even tried to do so.

Are there any sleep hygiene tips you can offer for parents to help their sleepy teen? Most parents can locate sleep hygiene tips if they search several websites on the Internet. This may work for some teenagers, but as a stand-alone treatment, these are not recommended to help people who have significant sleep problems.

Are there any tell-tale signs to look out for that may indicate a sleep issue? Parents are not usually aware of the severity of their teenager’s difficulty to fall asleep at night as the parents often fall asleep before their teens. So the first indicator they see is their teen’s difficulty getting up out of bed. But the key questions I ask parents are “Does your teen sleep-in on weekends, and if so, when do they sleep-in until?”, “Does your teen think they have a sleep problem, and if so, do they want to do something about it?” Thus, if their teens are waking up more than 2 hours later on weekends than they do on school mornings, and their teens answer “yes” to the second question. Then it’s time to do some research and seek professional help.

Can bright light therapy help teens? Bright light therapy has been used in multiple research studies around the world for people who fall asleep late and wake up late. Indeed, our research group was the first to perform a controlled study showing that bright light therapy was effective to use for adolescents with this problem, and the benefits lasted for 6 months after treatment stopped. New studies performed in other countries (e.g., Norway) have been published this year and also show bright light therapy works. It works by signalling to the body clock (via the eyes) that it’s time to wake up and start the day. So we gradually provide light earlier and earlier to teenagers so we trick their body clock into believing the day is starting earlier. As a result, teens begin to feel more alert in the morning and because they are waking up earlier, they begin to fall asleep earlier. It does take effort, but our data show improvements can occur over 3 weeks, which is pretty impressive considering the average amount of time these teens have had this problem for is just under 5 years!